How do Norwegians' use of complementary and alternative medicine (CAM) and dietary supplements develop over time? How is their health developing, and how do their costs for this develop? What differences can be seen between the most recent survey and the older ones? Do we see any patterns or trends?
This article provides answers to these questions, as they have been measured in NAFKAMs population survey every two years since 2012. Changes are presented in percentage points (pp), Norwegian kroner (NOK) and in percentage, expressing the differences between the most recent survey and the previous one; as well as between the newest and the oldest (2012). The data were analyzed by Agnete E. Kristoffersen at NAFKAM, who also authored this report together with Ola Lillenes.
The reports from each of the editions are publically available, and can be found here: 2022 - 2020 - 2018 - 2016 - 2014 - 2012.
You may also read our introductory article on the NAFKAM national survey in general, which outlines its methodology, structure etc.
What is measured?
"Complementary and alternative medicine" (CAM) includes health-related treatment from a provider in line with the definition in §2 in the Norwegian Act No 64 about complementary and alternative medicine; use of herbs/ natural remedies (plant-based drugs), and/or the use of self-help techniques. The term "treatment" also includes advice from a provider on diet/lifestyle changes, and/or guidance from instructors providing training in various self-help techniques for self-treatment and health-related purposes.
The use of dietary supplements is not initially considered CAM, but NAFKAM has a special sub-mission from the Norwegian health authorities to monitor and report the population's use of this as well. For practical reasons, we collect this at the same time as we investigate the use of CAM.
1. Introduction
The size and composition of the Norwegian population is yearly monitored by Statistics Norway. The gender-composition of NAFKAMs surveys aim to reflect this, on the basis of its 1,000 interviews of people aged 18 years or more:
Table 1.1: Development of the adult Norwegian population, versus NAFKAMs surveys
| | 2012 | 2014 | 2016 | 2018 | 2020 | 2022 |
|---|
| Total population 18 yrs+ | 3,867,645 | 3,983,895 | 4,086,583 | 4,166,612 | 4,248,972 | 4,316,747 |
| % men | 49,8% | 50,0% | 50,1% | 50,1% | 50,2% | 50,2% |
| % women | 50,2% | 50,0% | 49,9% | 49,9% | 49,8% | 49,8% |
| % men in NAFKAM survey | 48,3% | 54,4% | 52,7% | 54,4% | 52,0% | 50,1% |
| % women in NAFKAM survey | 51,7% | 45,6% | 47,3% | 45,6% | 48,0% | 49,9% |
1. Development of popuation's use of CAM and dietary supplements
Table 2.1: Usage, independent of gender | % of all respondents | 2012 | 2014 | 2016 | 2018 | 2020 | 2022 | Change, 2012-22 | Change, 2020-22 |
|---|
| Total use of CAM | 45,3% | 41,0% | 35,8% | 36,5% | 39,3% | 38,3% | -7,0 pp (-15,5%) | -1,0 pp (-2,5%) |
| CAM treatment from providers | 36,6% | 30,9% | 23,5% | 22,4% | 20,7% | 24,9% | -11,7 pp (-32,0%) | +4,2 pp (+20,3%) |
| Herbs/ natural remedies (not supplements) | 12,0% | 10,7% | 10,8% | 9,6% | 9,3% | 13,8% | +1,8 pp (+15,0%) | +4,5 pp (+48,4%) |
| Self-help techniques | 12,4% | 14,4% | 14,3% | 16,9% | 21,8% | 18,1% | +5,7 pp (+46,0%) | -3,7 pp (-17,0%) |
| Supplements (not herbs) | 70,4% | 70,1% | 66,0% | 68,8% | 70,9% | 73,8% | +3,4 pp (+4,8%) | +2,9 pp (+4,1%) |
Table 2.2: Usage among men| % of male respondents | 2012 | 2014 | 2016 | 2018 | 2020 | 2022 | Change, 2012-22 | Change, 2020-22 |
|---|
| Total use of CAM | 36,3% | 33,1% | 27,1% | 28,0% | 30,7% | 29,9% | -6,4 pp (-17,6%) | -0,8 pp (-2,5%) |
| CAM treatment from providers | 27,1% | 26,6% | 18,3% | 16,9% | 15,5% | 20,0% | -7,2 pp (-26,4%) | +4,4 pp (+28,4%) |
| Herbs/ natural remedies (not supplements) | 9,4% | 8,0% | 7,7% | 7,7% | 8,8% | 10,0% | +0,6 pp (+6,1%) | +1,2 pp (+13,0%) |
| Self-help techniques | 7,0% | 7,7% | 6,5% | 10,7% | 15,4% | 10,0% | +3,0 pp (+42,5%) | -5,4 pp (-35,0%) |
| Supplements (not herbs) | 66,3% | 65,5% | 60,9% | 62,5% | 70,1% | 69,9% | +3,6 pp (+5,4%) | -0,2 pp (-0,3%) |
Table 2.3: Usage among women| % of female respondents | 2012 | 2014 | 2016 | 2018 | 2020 | 2022 | Change, 2012-22 | Change, 2020-22 |
|---|
| Total use of CAM | 53,7% | 50,5% | 45,5% | 46,8% | 48,6% | 46,7% | -7,0 pp (-13,0%) | -1,9 pp (-3,9%) |
| CAM treatment from providers | 45,5% | 36,1% | 29,3% | 29,1% | 26,2% | 29,9% | -15,7 pp (-34,4%) | +3,7 pp (+14,1%) |
| Herbs/ natural remedies (not supplements) | 14,5% | 13,9% | 14,2% | 11,9% | 9,8% | 17,6% | +7,9 pp (+21,7%) | +7,8 pp (+79,6%) |
| Self-help techniques | 17,3% | 22,4% | 23,0% | 24,4% | 28,7% | 26,3% | +8,9 pp (+51,3%) | -2,4 pp (-8,4%) |
| Supplements (not herbs) | 74,3% | 75,6% | 71,8% | 76,3% | 71,7% | 77,8% | +3,5 pp (+4,7%) | +6,1 pp (+8,5%) |
3. How are the costs to CAM and supplements developing (NOK/ kr)?
Table 3.1: Average cost per user, independent of gender
| Per user | 2012 | 2014 | 2016 | 2018 | 2020 | 2022 | Change, 2012-22 | Change, 2020-22 |
|---|
| Total use of CAM | 2610 | 2409 | 2547 | 2970 | 2561 | 4718 | +2108 kr (+80,8%) | +2156 kr (+84,2%) |
| CAM treatment from providers | 2498 | 2478 | 2738 | 3114 | 3770 | 4817 | +2319 kr (+92,8%) | +1047 kr (+27,8%) |
| Herbs/ natural remedies (not supplements) | 688 | 1206 | 1446 | 995 | 1016 | 3386 | +2698 kr (+392,1%) | +2370 kr (+233,3%) |
| Self-help techniques | 928 | 916 | 780 | 1733 | 535 | 1536 | +608 kr (+65,5%) | +1001 kr (+187,1) |
| Supplements (not herbs) | 1167 | 964 | 931 | 1013 | 1038 | 1095 | -72 kr (-6,2%) | +57 kr (+5,5%) |
Table 3.2: Men's costs
| Per male user | 2012 | 2014 | 2016 | 2018 | 2020 | 2022 | Change, 2012-22 | Change, 2020-22 |
|---|
| Total use of CAM | 2394 | 1753 | 1612 | 2159 | 2580 | 6967 | +4573 kr (+191,0%) | +4388 kr (+170,1%) |
| CAM treatment from providers | 2565 | 1753 | 1701 | 2569 | 3898 | 2599 | +34 kr (+1,3%) | -1299 kr (-33,3%) |
| Herbs/ natural remedies (not supplements) | 1701 | 1233 | 1449 | 1166 | 1332 | 5380 | +3680 kr (+216,4%) | +4048 kr (+303,1%) |
| Self-help techniques | 440 | 654 | 284 | 814 | 363 | 526 | +86 kr (+19,6%) | +163 kr (+45,0%) |
| Supplements (not herbs) | 1112 | 930 | 849 | 1038 | 1125 | 924 | -188 kr (-16,9%) | -201 kr (-17,9%) |
Table 3.3: Women's costs
| Per female user | 2012 | 2014 | 2016 | 2018 | 2020 | 2022 | Endringer, 2012-22 | Endringer, 2020-22 |
|---|
| Total use of CAM | 2745 | 2926 | 3174 | 3561 | 2549 | 3682 | +937 kr (+34,1%) | +1133 kr (+44,5%) |
| CAM treatment from providers | 2461 | 3094 | 3472 | 3491 | 3687 | 6324 | +3863 kr (+156,9%) | +2637 kr (+71,5%) |
| Herbs/ natural remedies (not supplements) | 1346 | 1188 | 1499 | 862 | 806 | 2253 | +906 kr (+67,3%) | +1546 kr (+218,9%) |
| Self-help techniques | 1142 | 1027 | 1000 | 2258 | 635 | 1921 | +778 kr (+68,1%) | +1286 kr (+202,6%) |
| Supplements (not herbs) | 1214 | 1000 | 1075 | 989 | 945 | 1253 | +39 kr (+3,2%) | +307 kr (+32,5%) |
4. How is the usage of CAM providers developing?
Table 4.1: Usage of predefined CAM therapies, among all respondents
| CAM therapy name | 2012 | 2014 | 2016 | 2018 | 2020 | 2022 | Change, 2012-22 | Change, 2020-22 |
|---|
| Total use of CAM therapy from a provider | 36,6% | 30,9% | 23,5% | 22,4% | 20,7% | 24,9% | -11,7 pp (-32,0%) | +4,2 pp (+20,3%) |
| Acupuncture | 9,9% | 7,1% | 5,5% | 4,7% | 4,8% | 5,3% | -4,6 pp (-46,4%) | +0,5 pp (+10,4%) |
| Cupping | - | - | 1,3% | 0,5% | 0,7% | 1,5% | - | +0,8 pp (+114,3%) |
| Gestalt therapy | - | 0,2% | - | - | - | - | - | - |
| Homeopathy | 3,0% | 1,8% | 0,9% | 0,7% | 0,4 | 1,3% | -1,7 pp/ (-56,7%) | +0,9 pp (+225%) |
| Kinesiology | 1,7% | 1,1% | 0,7% | 0,3% | 0,4% | - | - | - |
| Massage therapy | 22,2% | 20,3% | 14,3% | 14,1% | 14,0% | 17,4% | -4,8 pp (-21,6%) | +3,4 pp (+24,3%) |
| Naprapathy | - | 4,6% | 2,7% | 2,7% | 2,9% | 5,1% | - | +2,2 pp (+75,6%) |
| Naturopathy | 2,0% | - | - | - | - | - | - | - |
| Osteopathy | - | - | 1,4% | 1,1% | 1,4% | 3,4% | - | +2,0 pp (+143%) |
| Other CAM therapies (not on the list) | 4,4% | 4,0% | 1,8% | 1,7% | 1,5% | 0,9% | -3,5 pp (-79,5%) | -0,6 pp (-66,7%) |
| Psychotherapy (not from a psychologist/ psychiatrist) | 2,0% | - | - | - | - | 2,8% | +0,8 pp (+40,0%) | - |
| Reflexology | 4,2% | 3,1% | 2,2% | 1,2% | 1,2% | 1,7% | -2,5 pp (-59,5%) | +0,5 pp (+41,7%) |
| Reiki healing | 3,8% | 2,8% | 1,2% | 2,3% | 1,4% | 2,3% | -1,5 pp (-39,5%) | +0,9 pp (+64,3%) |
| Thought Field Therapy (TFT) | - | 0,9% | - | - | - | - | - | - |
5. How is usage of CAM and supplements developing, gender-wise?
Table 5.1: Male users
| % of all men in the survey | 2012 | 2014 | 2016 | 2018 | 2020 | 2022 | Change, 2012-22 | Change, 2020-22 |
|---|
| Total use of CAM | 38,7% | 43,9% | 39,9% | 41,6% | 40,6% | 39,2% | +0,5 pp (+1,2%) | -1,4 pp (+3,4%) |
| CAM treatment from providers | 35,7% | 46,8% | 41,0% | 40,9% | 39,1% | 40,2% | +4,4 pp (+12,4%) | +1,1 pp (+2,8%) |
| Herbs/ natural remedies (not supplements) | 37,7% | 40,8% | 37,5% | 43,6% | 49,5% | 36,2% | -1,5 pp (-3,9%) | -13,3 pp (-26,9%) |
| Self-help techniques | 27,4% | 29,0% | 23,9% | 34,3% | 36,7% | 27,6% | +0,3 pp (+1,0%) | -9,1 pp (-24,8%) |
| Supplements (not herbs) | 45,4% | 50,8% | 48,6% | 49,4% | 51,4% | 47,4% | +2,0 pp (+4,4%) | -4,0 pp (-7,8%) |
Table 5.2: Female users
| % of all women in the survey | 2012 | 2014 | 2016 | 2018 | 2020 | 2022 | Change, 2012-22 | Change, 2020-22 |
|---|
| Total use of CAM | 61,3% | 56,1% | 60,1% | 58,4% | 59,4% | 60,8% | -0,5 pp (-0,8%) | +1,4 pp (+2,4%) |
| CAM treatment from providers | 64,3% | 53,2% | 59,0% | 59,1% | 60,9% | 59,8% | -4,4 pp (-6,9%) | -1,1 pp (-1,8%) |
| Herbs/ natural remedies (not supplements) | 62,3% | 59,2% | 62,5% | 56,4% | 50,5% | 63,8% | +1,5 pp (+2,4%) | +13,3 pp (+26,3%) |
| Self-help techniques | 72,6% | 71,0% | 76,1% | 65,7% | 63,3% | 72,4% | -0,2 pp (-0,4%) | +9,1 pp (+14,4%) |
| Supplements (not herbs) | 54,6% | 49,2% | 51,4% | 50,6% | 48,6% | 52,6% | -2,0 pp (-3,7%) | +4,0 pp (+8,2%) |
6. Respondents' self-reported health status
Table 6.1: Those who use CAM
| | 2012 | 2014 | 2016 | 2018 | 2020 | 2022 | Change, 2012-22 | Change, 2020-22 |
|---|
| Good health | 77% | 77% | 77% | 78% | 74% | 71% | -6,0 pp (-7,8%) | -3,0 pp (+5,4%) |
| Neither good nor poor | 15% | 16% | 15% | 14% | 17% | 18% | +3,0 pp (+20,0%) | +1,0 pp (+5,9%) |
| Poor health | 7% | 7% | 7% | 8% | 9% | 11% | +4,0 pp (+57,1%) | +2,0 pp (+22,2%) |
| Don't know/ won't say | 1% | - | 1% | - | - | - | - | - |
| Have a long-term (chronic) disease | | | | | 38% | 41% | - | +3,0 pp (+7,9%) |
Table 6.2: Those who don't use CAM
| | 2012 | 2014 | 2016 | 2018 | 2020 | 2022 | Change, 2012-22 | Change, 2020-22 |
|---|
| Good health | 81% | 84% | 82% | 82% | 79% | 78% | -3,0 pp (-3,7%) | -1,0 pp (-1,3%) |
| Neither good nor poor | 14% | 12% | 13% | 13% | 13% | 16% | -2,0 pp (-14,3%) | +3,0 pp (+23,1%) |
| Poor health | 5% | 4% | 5% | 5% | 7% | 6% | +1,0 pp (+20,0%) | -1,0 pp (-14,3%) |
| Don't know/ won't say | - | - | - | - | 1% | - | - | - |
| Have a long-term (chronic) disease | - | - | - | - | 35% | 30% | - | -5,0 pp (-14,3%) |
"-" means no data; there was no question/ answer about this in the specific survey.
7. Users' experiences with CAM
Table 7.1: Users' experiences of positive effects, lack of effect and negative effects
| | 2012 | 2014 | 2016 | 2018 | 2020 | 2022 | Change, 2012-22 | Change, 2020-22 |
|---|
| Experienced positive health effects | - | - | 58% | 63% | 59% | 89% | - | +30,0 pp (+50,8%) |
| Experienced no effect | - | - | 41% | 32% | 31% | 10% | - | -21,0 pp (-67,7%) |
| Experienced negative health effects (worsening of condition, adverse effects, interactions etc) | 2% | 2% | 4% | 7% | 6% | 5% | +3,0 pp (+150%) | -1,0 pp (-16,7%) |
These were three separate questions. Thus the categories are not mutually exclusive; users may e.g have experienced both positive and negative effects (with the same or different therapies/ from the same or different provider, etc).
"-" means no data; there was no question/ answer about this in the specific survey.
